Summaries of health policy coverage from major news organizations

Research Roundup: Residents’ Test Ordering Habits; Housing And Health; And Government Responsibility

Editorial pages focus on these and other health issues.

JAMA Internal Medicine:
Analysis Of Diagnostic Test Ordering Habits Among Internal Medicine Residents
The Dartmouth Atlas of Health Care sheds light on wide variations in spending for Medicare beneficiaries in the 6 months before their death. That report has led to several efforts to better standardize patient care. High-value care has been defined as the seventh competency, with national efforts to educate physicians and physicians in training about how to deliver higher-quality care, while decreasing the cost of that care. Medical students and residents are particular targets for this effort because of the known “imprinting,” or sustained influence, that the training environment has on practice habits during a physician’s career. Kahneman and colleagues found that professionals express a much greater-than-expected degree of variability in the outcomes of their work, even when given the same data with which to base their conclusions. We are aware of 2 previous studies that showed a large degree of variability in resident patterns of test ordering. One study analyzed outpatient test ordering in 1987, and another, “practice intensity” in 2015. (Geleris, 10/8)

Pew Research Center:
60% In US Say Health Care Coverage Is Government’s Responsibility
Six-in-ten Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage, including 31% who support a “single payer” approach to health insurance, according to a new national survey by Pew Research Center. These views are little changed from last year, but the share saying health care coverage is a government responsibility remains significantly higher than it was from 2008 through 2016 (51% said this in 2016, compared with 60% today). (Kiley, 10/3)

Health Affairs:
Medicare Beneficiaries Living In Housing With Supportive Services Experienced Lower Hospital Use Than Others
There is strong evidence that housing conditions affect population health, but evidence is limited on the extent to which housing with supportive social services can maintain population health and reduce the use of expensive hospital services. We examined a nonprofit, community-based program in Queens, New York, that supplied affordable housing with supportive social services to elderly Medicare beneficiaries. We evaluated whether this program reduced hospital use, including hospital discharges for ambulatory care–sensitive conditions (ACSCs). (Gusmano, 10/1)